Provider Demographics
NPI:1295221422
Name:FLEXOGENIX OKLAHOMA, PC
Entity Type:Organization
Organization Name:FLEXOGENIX OKLAHOMA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO/CBDO
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-455-7804
Mailing Address - Street 1:1000 S HOPE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-4058
Mailing Address - Country:US
Mailing Address - Phone:213-455-7803
Mailing Address - Fax:213-261-3816
Practice Address - Street 1:9300 N KELLEY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-2427
Practice Address - Country:US
Practice Address - Phone:213-455-7804
Practice Address - Fax:213-261-3816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies